Do You Have FH?

The cholesterol-watching world is filled to the brim with acronyms and easily confused verbiage.  Who can remember what LDL and HDL stand for – much less which is the good and which is the bad cholesterol?  And then there’s Apo-B and LDL particle size to boot. But today I learned one that was total news to me: FH.

Turns out, FH stands for Familial Hypercholesterolemia which, in a nutshell, is very high LDL (bad) cholesterol that is caused by genetics. A more complete definition is given on The FH Foundation website:

FHlogo“FH is short for Familial Hypercholesterolemia. It is an inherited disorder that leads to aggressive and premature cardiovascular disease. This includes problems like heart attacks, strokes, and even narrowing of our heart valves. For individuals with FH, although diet and lifestyle are important, they are not the cause of high LDL. In FH patients, genetic mutations make the liver incapable of metabolizing (or removing) excess LDL. The result is very high LDL levels which can lead to premature cardiovascular disease (CVD).”

I was amazed to find there’s a site – indeed, an entire foundation – dedicated to high cholesterol caused by genetics.  And a bit miffed – because I know my high cholesterol is genetic… so I can’t believe I didn’t know about this very useful source of information.

And it’s important – because FH is a serious condition and essentially requires choleterol-lowering medication or other intervention:

“Nearly 100% of people with FH will require cholesterol-lowering medications. For some people with FH, more aggressive measures are needed, including LDL-apheresis (a very simple procedure in which LDL-C cholesterol is removed from the blood on a weekly or biweekly basis.)

The American Academy of Pediatrics recommends that if a family has a pattern of early heart attacks or heart disease defined as before age 55 for men and 65 for women, children in that family should have cholesterol testing after the age of 2 years and before age 10.”

All this very sobering information compelled me to track down the excel spreadsheet I use to track my cholesterol results over time.  I was quite pleased to discover that although my high cholesterol is largely caused by genetics, it does not look like I have FH. In my most recent test, I’d brought my LDL (bad) cholesterol down through diet and exercise to 132 (under 130 was the goal before new guidelines were established).  And according to The FH Foundation website, FH is suspected when untreated LDL is above 190 (or 160 in children).

Whew.  Good news for me on the FH front.

Not so good news for me to ‘discover’ that my last cholesterol test was in March 2013.  Um, more than a year and a half ago.  It seems I have “forgotten” to keep track of my cholesterol levels.  Probably because I spent a lot of time this past year at Shake Shack.

So next week, at my annual ob/gyn appointment, I’ll take the blood test order my doctor always gives me and use it to have my cholesterol tested.

And if you have high LDL cholesterol that has not declined with diet and exercise and/or a family history of early heart disease / heart attacks, consider learning more about FH at The FH Foundation site and discuss with your doctor.

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